Remote CPhT for Pharmacy Benefits & Medicaid

Gainwell Technologies; Massachusetts; Remote; USD 39,000 - 52,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Generous vacation policy

Educational assistance

Job summary

Gainwell Technologies is hiring a Certified Pharmacy Technician for a fully remote role supporting Rhode Island Medicaid and other state programs. You will handle pharmacy claims, prior authorizations, and provider support, coordinating with state agencies and internal teams to ensure accurate program administration.

The ideal candidate has managed care or PBM experience, strong communication, and the ability to navigate multiple systems in a fast-paced remote environment.

Qualifications

• Active Certified Pharmacy Technician credential (PTCB/CPhT, ExCPT, or equivalent) required.
• Two or more years of relevant pharmacy technician experience.
• Experience with pharmacy prior authorizations, prescription claims, medication terminology, and member/provider/pharmacy support.
• Experience with POS claims, HCPCS, provider enrollment, formularies or related program operations is desirable.
• Strong communication, research, problem solving, and organizational skills in a fast-paced remote environment.

Responsibilities

• Maintain day-to-day relationships with state agency personnel and support eligibility updates, reporting, formulary activities and prior authorization support.
• Support state agency pharmacy programs, policies, processes, and reporting requirements including POS and HCPCS adjudication.
• Review, research, and process pharmacy prior authorization requests in line with policies and SLAs.
• Research and resolve program, member, provider, and pharmacy inquiries with accurate documentation.
• Collaborate with internal departments on pharmacy initiatives to improve quality and operational performance.

Skills

Pharmacy experience

Communication

Research

Problem solving

Computer skills

Organizational skills

Tools

POS claims systems

HCPCS

Job description

Gainwell Technologies is hiring a Certified Pharmacy Technician for a fully remote role supporting Rhode Island Medicaid and other state programs. You will handle pharmacy claims, prior authorizations, and provider support, coordinating with state agencies and internal teams to ensure accurate program administration.

The ideal candidate has managed care or PBM experience, strong communication, and the ability to navigate multiple systems in a fast-paced remote environment.